Harmful effects of lithium-ion battery thermal runaway: scale-up tests from cell to second-life modules.

For a comprehensive safety assessment of stationary lithium-ion-battery applications, it is necessary to better understand the consequences of thermal runaway (TR). In this study, experimental tests comprising twelve TR experiments including four single-cell tests, two cell stack tests and six second-life module tests (2.65 kW h and 6.85 kW h) with an NMC-cathode under similar initial conditions were conducted. The temperature (direct at cells/modules and in near field), mass loss, cell/module voltage, and qualitative vent gas composition (Fourier transform infrared (FTIR) and diode laser spectroscopy (DLS) for HF) were measured. The results of the tests showed that the battery TR is accompanied by severe and in some cases violent chemical reactions. In most cases, TR was not accompanied by pre-gassing of the modules. Jet flames up to a length of 5 m and fragment throwing to distances to more than 30 m were detected. The TR of the tested modules was accompanied by significant mass loss of up to 82%. The maximum HF concentration measured was 76 ppm, whereby the measured HF concentrations in the module tests were not necessarily higher than that in the cell stack tests. Subsequently, an explosion of the released vent gas occurred in one of the tests, resulting in the intensification of the negative consequences. According to the evaluation of the gas measurements with regard to toxicity base on the "Acute Exposure Guideline Levels" (AEGL), there is some concern with regards to CO, which may be equally as important to consider as the release of HF.

"We are Human too.": The Challenges of Being an End-of-Life Doula.

End-of-life (EOL) doulas are emerging professionals who provide an intimate approach to the death process by focusing on the psychological, social, spiritual, and emotional needs of dying individuals. EOL doula work is stressful; it exposes individuals to recurring stressors such as suffering and grief. Trained professionals are needed to help advocate for the dying individual and their families. Despite the growing literature on EOL doulas, information regarding the challenges of being an EOL doula is underrepresented in the literature. This paper is one of the first to address this concept. Twelve in-depth, semi-structured interviews regarding the EOL doula experience were conducted as a part of a larger exploratory study. Three overarching themes emerged from the larger project: motivations to become an EOL doula, roles of an EOL doula, and challenges of an EOL doula. In this article, only challenges of EOL are discussed, along with subsequent subordinate themes.

Lesbian, Gay, and Bisexual Widows' Experiences of Grief, Identity, and Support: A Qualitative Study of Relationships Following the Loss of a Spouse or Partner.

OBJECTIVES: Research with lesbian, gay, and bisexual (LGB) older widows rarely focuses on familial relationships. Studies on heterosexual spousal bereavement indicate older widows face issues influencing identity but show resilience by maintaining close relationships with adult children and extended family. Though research with older LGB widows suggests similarities around loss and resilience, grief and family engagement are markedly different. METHODS: Guided by Relational Cultural Theory, which illuminates how LGB women cope through connection/disconnection, this qualitative descriptive study employed semistructured, open-ended interviews with 16 LGB women, 60-85 years of age from across the United States who had lost a spouse or partner within the past 5 years. We conducted interviews regarding the perception of self as bereaved LGB women and sustained or altered relationships with biological and chosen families following the loss of their spouses/partners. RESULTS: Findings are illustrated in three themes around acceptance, support, and identity. Participants: (a) experienced differing levels of acceptance, tolerance, and inclusion from biological families; (b) experienced family or friends "disappearing" or providing critical support following a spouse/partner's death; and (c) negotiated challenges by creating or seeking out families of choice, new communities, and a better understanding of themselves. DISCUSSION: While LGB widows share some grief experiences with heterosexual widows, they also experience varying biological family acceptance and support, as well as the need for friends and families of choice as advocates. It is important to recognize the unique consequences of spousal loss for this population and be cognizant of the differences in normative grief.

"Would you like me to take your hand?": Introduction to End of Life Doulas.

End-of-life (EOL) doulas are care providers and companions that offer spiritual, emotional, psychosocial, or psychological care to a person who is dying as well as their family and loved ones (Fukuzawa & Kondo, 2017). However, much like other options for EOL care (e.g., hospice, palliative care), their practice is often underutilized and misunderstood. There is limited research on EOL doulas, including who they are and what they do, leaving an opening for future studies to explore the topic (Krawczyk & Rush, 2020). As part of a larger investigation to gather information on EOL doulas, 12 in-depth, semi-structured interviews were conducted with certified doulas regarding their experiences. Three themes emerged from this project: motivations to become an EOL doula, roles of an EOL doula, and challenges of an EOL doula. In this article, only two themes, motivations to become an EOL doula and roles of an EOL doula are discussed.

Reliability and validity varies among smartphone apps for range of motion measurements of the lower extremity: a systematic review.

The aim of this review was to determine whether smartphone applications are reliable and valid to measure range of motion (RoM) in lower extremity joints. A literature search was performed up to October 2020 in the databases PubMed and Cochrane Library. Studies that reported reliability or validity of smartphone applications for RoM measurements were included. The study quality was assessed with the QUADAS-2 tool and baseline information, validity and reliability were extracted. Twenty-five studies were included in the review. Eighteen studies examined knee RoM, whereof two apps were analysed as having good to excellent reliability and validity for knee flexion ("DrGoniometer", "Angle") and one app showed good results for knee extension ("DrGoniometer"). Eight studies analysed ankle RoM. One of these apps showed good intra-rater reliability and excellent validity for dorsiflexion RoM ("iHandy level"), another app showed excellent reliability and moderate validity for plantarflexion RoM ("Coach's Eye"). All other apps concerning lower extremity RoM had either insufficient results, lacked study quality or were no longer available. Some apps are reliable and valid to measure RoM in the knee and ankle joint. No app can be recommended for hip RoM measurement without restrictions.

Experiences of educators who identify as lesbian, gay, and bisexual.

The focus of the phenomenological qualitative study was on the lived experiences of U.S. educators who identified as lesbian, gay, and bisexual (LGB). Life story data regarding stress, coping, and identity were gathered, triangulated, and analyzed from 24 U.S. educators who identified as LGB teachers, mentors, and coaches. Four themes resulted: (a) subscribing to a helping identity, (b) being effective as an educator, (c) experiencing different levels of support, and (d) being out about sexual orientation to different degrees. Recommendations for future research are provided.

"I Could Do Stereotypical Old People Things but I Feel Like I Would Get Bored With That Stuff": College Students' Proactive Steps to Avoid Negative Aspects of Aging.

The preventive and corrective proactivity model explores how internal and external resources mediate age-related stressors to counter negative outcomes of aging. Older adults' proactivity about their future is consistently associated with higher quality of life, but research has not explored younger adults' perceptions of their aging. We used interpretive phenomenology analysis to analyze 24 students' essays from the beginning and end of an introductory gerontology course to understand anticipated adaptation to their 75-year-old self. The superordinate theme proactive steps to avoid negative aspects of aging comprised five subordinate themes (being productive, exercising and eating right, being financially stable, being socially connected, and the roles of older adults). Students presented unrealistically positive selves at 75 and discussed how to maintain and adapt to redefine their aging experience. Findings have implications for research on adaption, proactivity, and the future-self, and suggest that pedagogy incorporates realistic expectations of aging.

Improving the Chromosome-Level Genome Assembly of the Siamese Fighting Fish (Betta splendens) in a University Master's Course.

Ever decreasing costs along with advances in sequencing and library preparation technologies enable even small research groups to generate chromosome-level assemblies today. Here we report the generation of an improved chromosome-level assembly for the Siamese fighting fish (Betta splendens) that was carried out during a practical university master's course. The Siamese fighting fish is a popular aquarium fish and an emerging model species for research on aggressive behavior. We updated the current genome assembly by generating a new long-read nanopore-based assembly with subsequent scaffolding to chromosome-level using previously published Hi-C data. The use of ∼35x nanopore-based long-read data sequenced on a MinION platform (Oxford Nanopore Technologies) allowed us to generate a baseline assembly of only 1,276 contigs with a contig N50 of 2.1 Mbp, and a total length of 441 Mbp. Scaffolding using the Hi-C data resulted in 109 scaffolds with a scaffold N50 of 20.7 Mbp. More than 99% of the assembly is comprised in 21 scaffolds. The assembly showed the presence of 96.1% complete BUSCO genes from the Actinopterygii dataset indicating a high quality of the assembly. We present an improved full chromosome-level assembly of the Siamese fighting fish generated during a university master's course. The use of ∼35× long-read nanopore data drastically improved the baseline assembly in terms of continuity. We show that relatively in-expensive high-throughput sequencing technologies such as the long-read MinION sequencing platform can be used in educational settings allowing the students to gain practical skills in modern genomics and generate high quality results that benefit downstream research projects.

When I'm 75: College Students' Self Perceptions of the Challenges of Aging.

Despite robust literature on people's attitudes toward aging, far less is known about attitudes toward one's own aging, especially among college students. We examined college students' self-perceptions of the challenges of aging using essays from a "When I'm 75" assignment implemented at the beginning and end of the semester in an introductory gerontology course. Interpretive Phenomenological Analysis was used to analyze 24 students' perceptions of their own aging at age 75. The superordinate theme, challenges of aging, was identified along with five subordinate themes: deterioration, age-related impairments, mental health, loneliness and loss, and experiencing ageism. Findings suggest that after completing the course, students both demonstrated an understanding of realistic age-related changes and had (contradictory) stereotypical ideas of what it would be like to be 75. Findings have implications for research that continues to evaluate self-perceptions and contributes to the development of pedagogical strategies and tools that promote students' optimal aging.

"So we basically let them struggle": Student perceptions of challenges in intergenerational Service-Learning.

Service-learning is a widely used pedagogical practice that integrates community involvement and civic engagement into the classroom. Benefits of service-learning in gerontology include an increased sense of personal growth, greater knowledge of aging, and enhanced interest in aging-related careers. However, relatively little research has specifically explored the challenges associated with intergenerational service-learning. A focus group documented the experiences of 19 students who were required to participate in at least 20 hours of intergenerational service-learning for an introductory gerontology course. Because an administrative error prevented students from knowing about the service-learning requirement until they were enrolled, these participants were well qualified to discuss the challenges and positive aspects of their experiences. In addition to confirming known benefits of service-learning, three major themes regarding challenges emerged: lack of communication, the need for guidance, and creating meaningful relationships. This study provides suggestions for further development of "best practice" guidelines unique to intergenerational service-learning.

Impact of life stories on college students' positive and negative attitudes toward older adults.

Gerontological educators are increasingly interested in reducing college students' negative, and promoting their positive, attitudes toward older adults. Over the course of a semester, students from six 4-year institutions viewed three life story videos (documentaries) of older adults and completed pre- and posttest surveys that assessed their positive (Allophilia Scale) and negative (Fraboni Scale of Ageism) attitudes. The authors assessed changes in attitudinal scales between treatment (with videos, n = 80) and control (no video, n = 40) groups. Change score analysis with 95% bias-corrected bootstrap confidence intervals estimated the effects of the documentaries on students' attitudes. The treatment group showed significant increases in kinship, engagement, and enthusiasm, and decreases in antilocution and avoidance (all ps <.05). There was no significant change in affect, comfort, or discrimination. This study demonstrated how video stories impact students' attitudes about older adults.

Resection of Locally Advanced Pancreatic Neoplasms after Neoadjuvant Chemotherapy with Nab-Paclitaxel and Gemcitabine following FOLFIRINOX Failure.

The incidence of pancreatic cancer has dramatically increased over the past years, but the prognosis has not improved. Between 30 and 40% of tumors are considered locally advanced, essentially due to vascular involvement. In recent years, new chemotherapy protocols with high response rates have been developed. FOLFIRINOX seems to be an interesting option in this situation, but hematologic toxicity could be an obstacle to its prescription. Nab-paclitaxel and gemcitabine offer significant response rates with a reasonable safety profile. We report here a single-center experience of 2 cases with a locally advanced pancreatic cancer initially considered unresectable, progressive after first-line neoadjuvant FOLFIRINOX chemotherapy, and then treated with second-line nab-paclitaxel/gemcitabine chemotherapy.

Combination of pedCAT® for 3D Imaging in Standing Position With Pedography Shows No Statistical Correlation of Bone Position With Force/Pressure Distribution.

pedCAT(®) (CurveBeam, Warrington, PA) is a technology for 3-dimensional (3D) imaging with full weightbearing that has been proved to exactly visualize the 3D bone position. For the present study, a customized pedography sensor (Pliance; Novel, Munich, Germany) was inserted into the pedCAT(®). The aim of our study was to analyze the correlation of the bone position and force/pressure distribution. A prospective consecutive study of 50 patients was performed, starting July 28, 2014. All patients underwent a pedCAT(®) scan and simultaneous pedography with full weightbearing in the standing position. The following parameters were measured on the pedCAT(®) image for the right foot by 3 different investigators 3 times: lateral talo-first metatarsal angle, calcaneal pitch angle, and minimum height of the fifth metatarsal base, second to fifth metatarsal heads, and medial sesamoid. From the pedography data, the following parameters were defined using the standardized software algorithm: midfoot contact area, maximum force of midfoot, maximum force of midfoot lateral, maximum force of entire foot, and maximum pressure of first to fifth metatarsal. The values of the corresponding pedCAT(®) and pedographic parameters were correlated (Pearson). The intra- and interobserver reliability of the pedCAT(®) measurements were sufficient (analysis of variance, p > .8 for each, power >0.8). No sufficient correlation was found between the pedCAT(®) and pedographic parameters (r < 0.05 or r > -0.38).3D bone position did not correlate with the force and pressure distribution under the foot sole during simultaneous pedCAT(®) scanning and pedography. Thus, the bone positions measured with pedCAT(®) do not allow conclusions about the force and pressure distribution. However, the static pedographic parameters also do not allow conclusions about the 3D bone position.one position and force/pressure distribution are important parameters for diagnostics, planning, and follow-up examinations in foot and ankle surgery.

Donor Corneal Transplantation vs Boston Type 1 Keratoprosthesis in Patients with Previous Graft Failures: A Retrospective Single Center Study (An American Ophthalmological Society Thesis).

PURPOSE: To compare short-term outcomes of repeat penetrating keratoplasty (PK) to those of Boston type 1 keratoprosthesis (KPro). Our hypothesis was that visual outcomes were superior for KPro compared to PK. METHODS: This is a retrospective, nonrandomized, intermediate-term case series. Consecutive adults with one or more failed PKs who underwent either PK or KPro between January 2008 and December 2010 were included. Demographics, indication for the initial PK, comorbidities, concomitant procedures, and complications were considered. Only one procedure in each eye was included. All KPro procedures were retained in the analyses. RESULTS: Fifty-three patients underwent PK and 27 received KPro. Mean follow-up was 19.5 months in the PK group and 16.5 months in the KPro group. KPro eyes had worse mean preoperative vision (hand motions vs counting fingers, P=.01) and more comorbidities. In the postoperative period, 35% of PK eyes and 45% of KPro eyes attained best-ever visual acuity of 20/70. Forty-seven percent of PK eyes vs 40% of KPro eyes were able to retain this visual acuity. Two-year rate of failure to retain visual acuity better than the baseline was higher for PK eyes, though not at a statistically significant level (hazard ratio [HR]=1.67; 95% CI, 0.78-3.60; P=.19). Two-year cumulative rate of graft failure (loss of clarity for PK and removal/replacement for KPro) was higher for PK eyes (HR=3.23; 95% CI, 1.12-9.28; P=.03). Retinal detachment, endophthalmitis, and glaucoma rates were similar (P=.6 for all). CONCLUSIONS: These results demonstrate less frequent graft failure, greater visual improvement, and greater likelihood of maintaining the visual improvement in KPro eyes vs PK.

Intramedullary fixation in severe Charcot osteo-neuroarthropathy with foot deformity results in adequate correction without loss of correction - Results from a multi-centre study.

BACKGROUND: Charcot osteo-neuroarthropathy (CN) of the foot can induce severe instability and deformity. Results of a consecutive clinical multi-centre study with Midfoot Fusion Bolt (MFB, Synthes GmbH, Oberdorf, Switzerland) are reported. METHODS: All patients (aged 18 years and older) treated between 2009 and 2013 with surgical reconstruction of the midfoot with MFB for CN were included. Demographics, pre-surgical health status, details of foot pathology, details of surgery, postoperative treatment, treatment failure, and adverse events were registered. The following radiographic angles were measured on pre-op, post-op and last follow-up radiographs: talo-1st metatarsal (TMT) angle dorsoplantar and lateral view, and calcaneo-5th metatarsal angle. RESULTS: Forty-seven patients (48 feet) were included in three centres. In 38 patients (80.1%) diabetes was diagnosed. Wound healing problems occurred in 21% of patients and recurrent ulceration in 13%. Revision surgery for loss of correction was performed in three cases (6%). Union rate at final follow-up was 98%. Major amputation for deep infection was performed in two patients (4%), minor amputation at the foot level in three cases (6%). Failure was more frequent when only one MFB (instead of 2 or 3) was used and no Gastrocnemius lengthening was performed. Radiographic alignment significantly improved pre- versus postoperatively and preoperatively versus follow-up. CONCLUSIONS: Realignment and fixation with MFB in severe CN result in adequate correction with minimal loss of correction in the observed clinical course. The non-union rate was lower than previously reported. Stable fixation with MFB is a valuable treatment option for CN with minimal loss of correction and high union rates. The use of a minimum of two bolts is recommended to avoid recurrent deformity. Clinical Trials.gov: NCT01770639.

Ocular complications of primary Sjögren syndrome in men.

PURPOSE: To report the ocular complications of primary Sjögren syndrome (SS) in men. DESIGN: Retrospective cohort study. METHODS: setting: Tertiary-care SS center. PATIENT POPULATION: Total of 163 consecutive primary Sjögren syndrome patients evaluated between January 2007 and March 2013. MAIN OUTCOME MEASURE: Frequency of extraglandular ocular and systemic manifestations and serologic results in men compared to women. RESULTS: Fourteen of the 163 primary SS patients (9%) were men. On initial presentation, men were a decade older (61 vs 50 years, P < .01) and less likely than women to have a prior diagnosis of SS (43% vs 65%, P = .09). A majority of men reported dry eye on presentation (92%), albeit less chronic compared to women (5.9 vs 10.8 years, P = .07). Men were more likely to present with serious ocular complications than women (43% vs 11%, P = .001). Extraglandular systemic complications of SS (ie, vasculitis, interstitial nephritis) were also more common in men (64% vs 40%, P = .07). Further, men were more likely to be negative for anti-SSA/Ro, anti-SSB/La, and antinuclear antibodies than women (36% men vs 11% women, P = .01). CONCLUSION: Men with primary SS have a higher frequency of serious ocular and systemic manifestations. Although primary Sjögren syndrome is typically considered a disease of middle-aged women, it may be underdiagnosed and consequentially more severe in men. Physicians should have a lower threshold to test for SS in men with dry eye.

Ocular and systemic morbidity in a longitudinal cohort of Sjögren's syndrome.

PURPOSE: To report vision-threatening ocular manifestations of primary Sjögren's syndrome (SS). DESIGN: Retrospective review. PARTICIPANTS: Consecutive patients evaluated at an SS center between January 2007 and May 2011. METHODS: Data collection was completed in March 2013. The 2002 American-European consensus criteria were used for diagnosis of SS. MAIN OUTCOME MEASURES: Frequency of extraglandular ocular findings and timing of their diagnosis relative to that of SS and dry eye were assessed. RESULTS: One hundred sixty-three patients were included. Almost all patients (98%) had a history of dry eye for an average of 10.4 years (median, 7.9 years) before presentation. One or more extraglandular ocular manifestations were present in 40 patients (25%), and vision-threatening findings were present in 22 patients (13%). Twelve patients (55%) with a vision-threatening ocular finding did not have a diagnosis of SS at presentation. Sixty-eight patients (42%) had extraglandular systemic manifestations of SS. Patients with vision-threatening ocular findings were 3.9 times more likely to have systemic involvement (95% confidence interval, 1.4-11.0; P = 0.010). Peripheral neuropathy, interstitial nephritis, and vasculitis were more common in those with vision-threatening ocular findings compared with patients without (P < 0.05 for all). CONCLUSIONS: These results from a tertiary referral-based cohort demonstrate that primary SS frequently is associated with ocular and systemic complications. Dry eye precedes these findings on average by 1 decade. Therefore, ophthalmologists should consider assessing for SS in patients with clinically significant dry eye.

PedCAT for 3D-imaging in standing position allows for more accurate bone position (angle) measurement than radiographs or CT.

BACKGROUND: PedCAT (Curvebeam, Warrington, USA) is a new technology that allows 3D-imaging with full weight bearing which is not influenced by projection and/or foot orientation (as radiographs). The aim of this study was to compare time spent of the image acquisition, and comparison of specific bone position (angle) measurements between three imaging methods (radiographs, CT, pedCAT), and to analyze and compare measurement differences and inter- and intraobserver reliability. METHODS: In a prospective consecutive controlled study, 30 patients in which standard digital radiographs with full weight bearing in standing position (feet bilateral dorsoplantar and lateral views and Saltzman hindfoot view), CT without weight bearing, and pedCAT scan with full weight bearing in standing position were included, starting July 1, 2013. The following angles were measured for the right foot by three different investigators three times: 1st - 2nd intermetatarsal angle, talo-metatarsal 1-angle (TMT) both dorsoplantar and lateral projection, hindfoot angle, calcaneal pitch. The angles were digitally measured and compared (ANOVA with Post Hoc Scheffe test). RESULTS: The angles differed between radiographs, CT and pedCAT (ANOVA, all p≤.01). The angles differed between pedCAT and both radiographs and CT (Post Hoc Scheffe test, each p≤.05 except for TMT dorsoplantar and calcaneal pitch angels versus radiographs). CONCLUSIONS: The angles differed between radiographs, CT and pedCAT, indicating that only pedCAT is able to detect the correct angles. PedCAT includes weight bearing in contrast to CT. PedCAT prevents inaccuracies of projection and foot orientation in contrast to radiographs due to the 3D dataset which is principally independent from projection and foot orientation.

Cigarette smokers, never-smokers, and transitions: implications for successful aging.

One of the social identities held by people is defined by whether or not they smoke cigarettes. Although this identity can and does change for many people over the course of their lives, most research has not examined the effects of transitioning from a smoker to a non-smoker. Using a life span perspective, our analyses contrasted the extent to which successful aging is experienced by: (1) persons who ever smoked and those who never smoked; (2) former smokers and current smokers; and (3) persons who transitioned from being a smoker to being a non-smoker at different ages. Using data from a random sample of 5688 persons between the ages of 50 and 74 living in New Jersey, we found that persons who never smoked were most likely to age successfully; there were no differences in patterns of successful aging when all former smokers were compared to current smokers; and persons who quit smoking before age 30 experienced modest benefits compared with those who continued to smoke.